Neuroendocrine Tumors

Carcinoid Tumors or Neuroendocrine Carcinoma

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Neuroendocrine tumors (NETs) are typically found in the digestive tract, lungs, and pancreas. Sometimes called carcinoid tumors or neuroendocrine carcinoma, these types of tumors are often malignant, meaning they grow and may spread to other parts of the body, including the bones, liver, abdomen, and lymph nodes.

As specialists at one of the country’s leading cancer centers for people with neuroendocrine tumors, Duke oncologists and endocrinologists are experts at managing these cancerous tumors. Our goal is to treat your tumors and maximize your quality of life.

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How Neuroendocrine Tumors May Impact You

Neuroendocrine tumors may release hormones that can cause a range of problems with your digestive system, from common stomach issues like cramping and diarrhea to stomach ulcers. If a tumor forms in your abdomen, it could cause painful blockages in your intestine. People with neuroendocrine tumors often see changes in skin tone, like a rash or flushed face, and can experience trouble breathing. An imbalance in hormones can make your blood sugar go too low or high, impacting your energy levels and heart rate. While rare, a neuroendocrine tumor can also impact the function of your heart valves.

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Duke Health sees people for neuroendocrine tumor diagnosis and treatment at locations in Durham.

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Tests for Neuroendocrine Tumors

Several tests may be performed to accurately diagnose or confirm neuroendocrine tumors. If you have been referred to Duke, you may already have results from biopsies, blood tests, or scans. We’ll use these to guide your care and may run additional tests to develop your personalized treatment plan.

Blood and Urine Tests

These tests indicate the level of proteins or hormones in your body made by neuroendocrine tumors. Your provider will use the results to confirm the presence of tumors and determine how fast a neuroendocrine tumor may grow or spread.

Advanced Imaging

CT scans and MRI can help identify a tumor’s location and size.

Advanced PET Scan

PET scans detect neuroendocrine tumors based on how the tumors interact with medically safe radioactive drugs. For slow-growing neuroendocrine tumors, you may have an injection of a drug called DOTATATE that helps your doctor see neuroendocrine cells on a PET scan. For fast-growing tumors, you may have a specialized PET scan that uses radioactive sugar molecules to identify cancer cells.

Upper Endoscopy

During an upper endoscopy, a gastroenterologist inserts a small tube with a camera at its tip through your mouth to view your stomach and upper GI tract. Your doctor will look for tumor growth and may take a small tissue sample for examination to determine if cancer is present.

Colonoscopy

During a colonoscopy, a small tube with a camera at its tip is inserted through your rectum to examine the colon and/or your small intestine. A small tissue sample may be removed and examined to determine if cancer is present.

Echocardiogram

If a neuroendocrine tumor is producing hormones that could lead to of heart valve damage, an ultrasound of the heart may be performed to look for damage.

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Treatments for Neuroendocrine Tumors

Along with removing a tumor and trying to reduce any spread of cancer, oncologists and endocrinologists will work together to minimize changes in hormone levels that can cause stomach problems and flushing of your skin. If your tumor has metastasized, we have options for treatment.

Active Surveillance and Medication

If you have a slow-growing tumor that is not negatively impacting your health or quality of life, active surveillance may allow you to avoid or postpone surgery or other treatments. Medication may be prescribed to minimize side effects like diarrhea or blood sugar changes. Regular appointments will allow our specialists to actively monitor your health for changes that may require further treatment.

Hormone Therapy

Most people with neuroendocrine tumors receive hormone therapy via a monthly injection to reduce symptoms caused by hormonal imbalances. Hormone therapy may also help shrink the tumor.

Targeted Therapies

If your neuroendocrine tumor is cancerous, it may require certain kinds of proteins to grow. We can prescribe oral medication that can block those proteins and slow or stop growth.

Chemotherapy

Chemotherapy may be prescribed to kill cancer cells and stop them from growing. Your oncologist will determine whether chemotherapy is a good option to include in your treatment plan.

Surgery

Duke surgical oncologists specialize in the removal of neuroendocrine tumors and metastatic cancer. If surgery is an option for you, we'll work to remove as much of your tumor and additional tissue around your tumor as possible, which can help minimize spread. Sometimes surgery will be performed in coordination with other treatments to ensure we remove as much of the tumor as possible.

Image-Guided Ablative Therapies

Radiofrequency ablation (RFA), microwave ablation, and cryoablation are minimally invasive techniques that use extreme heat or cold to kill cancer cells. These procedures use a long, thin probe inserted through your skin. Transarterial embolization (TAE), transarterial chemoembolization (TACE), and transarterial radioembolization (TARE) use a catheter inserted into artery through your groin or wrist to deliver small beads to your tumor. The beads kill cancer cells by blocking blood flow to the tumor or by delivering chemotherapy or radioactive particles into the tumor.

Peptide Receptor Radionuclide Therapy

Intravenous drugs deliver radioactive particles to your tumor to slow or stop growth. Treatment consists of four doses of a radioactive drug every eight weeks.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

Why Choose Duke

Leaders in Treatment of Neuroendocrine Tumors
Duke Health is a leading referral center for people with neuroendocrine tumors, with specialists trained to deal with the rare disease. Our surgical oncologists are trained to safely remove tumors. They deliver acre through our endocrine-oncology program, which specializes in caring for people who receive endocrine cancer treatment.

A Team Approach to Your Care
Your team will include medical oncologists, surgeons, interventional radiologists, nuclear medicine specialists, endocrinologists, pathologists, dieticians, and pharmacists. We share information so everyone on your care team is up to date on your progress. Our goal is to ensure you experience the best possible outcome and maximize your quality of life.

Nutrition and Dietary Care
Your care team may connect you with dietitians and nutritionists who can help you manage stomach problems and keep you feeling as well as possible.

Advancing Research of Neuroendocrine Tumors
You may be eligible to participate in clinical trials that explore new therapies for neuroendocrine tumors before they become available elsewhere.

This page was medically reviewed on 01/11/2022 by

Michael A. Morse, MD, FACP, MHS | Medical Oncologist